Gastrostomy is defined as the establishment of a fistulous (i.e., acquired communication between a hollow structure and the exterior) opening (stoma) into the stomach (gastrostoma), with an external opening in the skin; usually for artificial feeding. It is one of the oldest operations performed, having appeared in writings as early as 1849. The usual reason for performing the operation in current practice is the patient's inability to tolerate an oral diet while having a functional gastrointestinal tract and a meaningful life expectancy. Although usually performed because of neurologic impairment, the list of reasons for gastrostomy continues to increase.
With refinements in surgical and anesthetic technique, surgical gastrostomy has become safe in spite of the generally debilitated population in whom it is performed. Additionally, several advantages over surgical methods have been provided by the introduction of the percutaneous endoscopic gastrostomy. Further, the recent explosion of laparoscopic technology has prompted minimally invasive placement of gastrostomies even for patients who may not be candidates for percutaneous endoscopic gastrostomies.
However, even with their popularity, the newer gastrostomy techniques still have significant shortcomings. Present technology requires surgery, laparoscopy, endoscopy, or percutaneous puncture (depending on the method used) as well as anesthesia (general, intravenous, local), antibiotic coverage, post-procedure analgesics, and delayed refeeding after the procedure.
Use of magnets in surgery has been previously reported. A method for cholecystogastrostomy involving magnetic compression was disclosed in Russian patent publication No. 1,708,313, published Jan. 30, 1992. Annular magnets were implanted endoscopically in the gall bladder via a temporary cholecystostomy and into the stomach via the oropharynx or an axial drainage catheter. The catheter simultaneously served a decompression function in patients with mechanical jaundice (cholestasis). After the anastomosis had been created, the drain was removed, together with the magnets. The complex procedure required perforation of the anterior abdominal wall, the anterior wall of the stomach, and an incision in the floor of the gall bladder.
Russian patent publication No. 1,725,851, published Apr. 4, 1992, discloses a device and surgical procedure for forming an intestinal anastomosis for treatment of large intestine obstruction. The device includes ring-shaped magnets and a forus-shaped guide, which is surgically implanted to aid in centering the magnets and reducing the risk of anastomotic incompetence.